Peterson, Matthew Wade
Peterson, Matthew Wade is an individual health care provider with primary practice located at 10456 S Redwood Rd , South Jordan UT 84095-8501. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Peterson, Matthew Wade can be contacted via phone (801) 878-9565.Contact Information
Primary practice address
10456 S Redwood Rd
South Jordan UT 84095-8501
Phone: (801) 878-9565
Fax: (801) 432-8072
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 370378-1202 | Utah |
Profile Details
| NPI number | 1326011891 |
|---|---|
| LBN Legal business name | Peterson, Matthew Wade |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 7th, 2006 |
| Last updated | Nov 19th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1326011891 | NPPES |
| Utah | MEDICAID | 870395551005 |
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